ABSTRACT
Due to the worldwide mission of the military, service members often find themselves isolated from their families and other important people in their lives. Historically, this has been especially problematic during periods of illness, as the isolation has precluded the meaningful involvement of families in patient care. With the increased availability of real-time video teleconferences (VTCs), however, providers may now gain access to family members. The Inpatient Psychiatry Department at Tripler has conducted therapeutic trials of family meetings using real time VTCs. These meetings are used to facilitate social support and mend family disconnections. The high clarity images offered through this system were instrumental in developing a virtual interactive social presence among the participants. Despite the potential benefits of VTC in gaining accessing to family support, there is little mention of such clinical family meetings in the medical literature. This report describes two case examples of the application of real-time family VTC in the management of mental illness.
Subject(s)
Family Therapy/methods , Mental Disorders/therapy , Military Medicine/methods , Telemedicine , Adult , Hawaii , Hospitals, Military , Humans , Male , Middle AgedABSTRACT
Alcohol Use Disorders are thought to be underdiagnosed in the geriatric population. A retrospective medical record review was performed on 383 patients who presented for outpatient geriatric assessment from 1985-1990. The record review included data on the alcohol consumption history, age, sex, presence of alcoholic beverages in the home, geriatric psychiatry evaluation, and alcohol-related diagnoses. Alcohol Use Disorders were recognized as contributing to medical problems in 10% of patients having a mean age of 78 years. All except one patient were found to be cognitively impaired. In addition, 9% of patients consumed alcohol on a regular basis and this consumption was not considered in the diagnosis, despite the presence of cognitive impairment. Twenty-five percent of cognitively impaired patients were consuming alcohol at the time of evaluation. These results indicate that alcohol consumption and AUD are common in cognitively impaired patients presenting for geriatric assessment. Recognition of Alcohol Use Disorders is essential, as chronic alcohol toxicity represents one cause of potentially reversible dementia. Because there are no validated instruments for alcoholism screening in cognitively impaired elderly patients, evaluation should include a past and present consumption history, a search for alcoholic beverages at the home visit, and possible psychiatric referral.
Subject(s)
Alcoholism/diagnosis , Dementia/diagnosis , Geriatric Assessment , Aged , Aged, 80 and over , Alcoholism/psychology , Dementia/psychology , Diagnosis, Differential , Female , Humans , Male , Mental Status Schedule , Psychiatric Status Rating ScalesSubject(s)
Aging/metabolism , Benzodiazepines/metabolism , Adult , Aged , Half-Life , Humans , Substance Withdrawal Syndrome/drug therapyABSTRACT
Acute ingestion of ethanol induces vasodilation and swelling of respiratory mucosa; it depresses respiratory centers resulting in hypotonia of oropharyngeal dilator muscles and inducing or aggravating sleep apnea. However, no association between the sleep apnea syndrome (SAS) and Alcohol Use Disorders (AUD) has been demonstrated.
